What are the Best Health Insurance Plans for Children in India?

As unfortunate and ominous as it may sound, children are the most susceptible to ailments, considering their “still-developing” immunity status. Much like adults, they too are vulnerable to a wide range of diseases from the common cold to cancer. Unfortunately, while a visit to the paediatrician can cure some of these ailments; some require extensive treatments that require a lumpsum expense.

Now, since, insurance is a protection tool based on the anticipation of our health and the subsequent effect on our finances, we are much less likely to have an intent towards purchasing a health insurance plan for children. But, a much more practical and financially smart decision would be to hope for the best and yet stay prepared for the worst when it comes to the health of your child.

After all, in the unfortunate event that leads to the hospitalisation of your child, the last thing you would want is to be financially constrained into opting for a mediocre healthcare and treatment service. With substantial funding via health insurance plans for your children, you can have access to the best paediatricians and ailment specialists across the country.

Keeping that in mind, let’s take a look at some of the best health insurance plans for children -

Best Health Insurance Plans for Children

What are the health insurance options for children in India?

In general, individual health insurance plans have an entry age of 18 years since insurers find that this is the minimum age when individuals can become financially independent and thus can afford a health policy. However, what about those below the age of 18?

Well, they have two options -

1. Family Floater coverage - In this type of health insurance policy, the child is covered in the plan along with other members of his/her family. The sum assured assigned under this policy can be used by any member from the insured group, including the child.

Advantages: In the case of children, the family health insurance policy has a particular perk - let’s imagine this -

Ashim (35 years old) has a family of 3 - his son (6 years old), and his parents (50 and 52 years old).

Now, in family floaters, the premiums are mostly decided as per the age of the oldest member of the policy since they have a depleting health condition, presenting higher payout risks.

On the other hand, his son will pose as the one insured member with the least possibility of payout considering his age and probabilities of acquiring any major ailments.

So, his son will have very little to no contribution towards increasing the premium for the plan, making it one of the most affordable options available.

Disadvantages: While a family health insurance plan for your children may be an affordable choice, there are a few things that you need to consider before you settle on this option -

Your child will be splitting the sum assured with the other insured members. While most family plans come with a decent coverage amount, when your policy has adults (who are more prone to ailments) in it, chances are that in case your child falls critically ill, you will find yourself short in the coverage section. The best foot forward in this case would be to go for a family health insurance plan that offers unlimited restoration.

2. Individual plans - Though rare, there are a few health insurance plans in the market that have lowered their entry ages to below 18 years. Such plans offer a unique set of advantages when they act as health insurance policies for children -

• Since children pose much fewer chances of payouts over hospitalisations or lengthy treatment cycles, insurers offer such plans at relatively affordable premiums.
• Most health insurance plans come with a No-Claim Bonus that can extend from 50% to 200%, based on your choice of insurer and policy. With a healthy child, this boost in coverage amount, without any spike in premiums can go a long way. Maybe by the time he/she makes their first claim, they will have a 200% raise on their coverage.
• With family health plans, children are covered only until they are 25/26 (varies depending on the insurer). Eventually, they have to port to an individual plan.
• Individual policies offer a child a substantial cover amount that can be of use in the unfortunate event that he/she needs to get treatment for any critical ailments.

However, on the other hand, individual plans for children also have a few downsides -

• Say you are a corporate employee with a spouse and two children. How many health insurance plans could you be tackling?

1 corporate health plan for yourself, 1 corporate plan for your spouse, 1 each for your children and then 1 each for the adult members of the family. 6 health insurance plans for a family of 4!

Keeping track of the progress in all these plans, paying timely premiums, and updating the health insurance add-ons is one massive feat that needs to be avoided.

• Irrespective of how affordable such plans are, unless you have the financial buffer to manage this, individual health insurance plans for children are an added expenditure that could have been managed by including your child in your family plan.

What are the Best Health Insurance Plans for Children in India?

As of now, there are very few health insurers that are offering effective and affordable health insurance plans for children. Here is a look at 2 of the most common and popular stables and their health insurance policies for children -

1. Care health insurance - Previously known as Religare Health Insurance Company Limited, Care has taken the market by storm over its affordable and diverse portfolio of policies that come with a unique perk - no loading charges. Needless to say, this is one of the reasons why they have a lower premium on their standard health insurance plans as compared to others in the industry.

Here is a look at some of their most popular health insurance plans for children, that is, health plans with lower entry age -

• Care Plus (Entry age: 5 years)

Care Plus is a solid pick as a health insurance plan for children considering that it is crafted for young people with nominal to no pre-existing medical conditions (except hypothyroid, blood pressure, etc.). Additionally, the plan offers accidental death benefits, an inflation shield, dental treatments, and a No-claim Bonus of 50% to 200%.

Drawbacks: Care Plus offers OPD coverage that is capped at ₹1500 to ₹2500 per year and at ₹350 per consultation. Needless to say, this amount is far from sufficing the realistic costs of visits to doctors (especially paediatricians) and yet it boosts the premium charges.

• Care Advantage (Entry age: 5 years)

Care Advantage is one of the most affordable plans in the market that also offers very high coverage. Apart from this, the plan has no room rent restrictions, restoration benefits, and no disease-wise sub-limits.

Drawbacks: Care Advantage might be an affordable plan in terms of premiums and its subsequent sum insured, however, it has quite a few hiccups. The policy offers no free health checkups; the restoration perk can be availed of only once a year; dental treatments (apart from ones caused by accidents) are not covered, and the No-Claim Bonus is capped at a measly 50%.

• Care Care (Entry age: 5 years)

Care Care is a decent plan overall with a few restrictions. This policy offers free annual health checkups, no copayment requirements (until you turn 61), no disease-wise sub-limits, and more.

Drawbacks: Care Care as a health insurance plan for children lacks a few important features like dental care, OPD coverage, etc. Moreover, the No-cLiam Bonus is also capped at a maximum of 50%.

In addition to the plan mentioned above, Care also offers the Care Enhance plan, which is a Super Top-Up plan. Since the entry age for this plan is 6 years, children can avail of this option to boost their coverage amount at affordable additions to their existing base premiums.

2. Star health insurance

Star is one of the oldest players in town across the insurance industry. Needless to say, the insurer does offer a diverse portfolio of health insurance plans, some of which have a lower entry age than 18.

However, Star’s recent history of closing down on a few of their long-standing insurance products, rejection of claims, and poor claim settlement support have been a concern for us. Best to look out for other options if you can.

Here’s a mention of a couple of health insurance plans for children from the stable of Star -

• Star Cardiac Care Platinum (Entry age: 7 years)

Cardiac issues are a common occurrence in newborns these days. However, a majority of health insurers are still reluctant to offer their policies to such individuals even if they have had their surgeries a long time ago.

Star’s Cardiac Care Platinum places a 7-year minimum intermittent period as eligibility for a cardiac surgery patient. If the potential policyholder has had no cardiac surgeries in the last 7 years, they can avail of this policy.

Overall, this policy is a decent consideration in case your child has had heart surgery in the past. It covers the cost of angiograms, supports heart transplants (with a minimum waiting period), a decent OPD coverage, free annual health checkups, and no copayments.

Drawbacks: Apart from the obvious issues with the insurer’s reputation in the industry, the plan also has certain disease-wise sub-limits, and no domiciliary coverage.

• Star Cancer Care Platinum (Entry age: 5 months)

The Cancer Care Platinum plan from the stable of Star is a decent pick considering it covers one of the rare ailments in the industry. The plan offers annual checkups for every claim-free year of up to ₹2500, nominal room rent restrictions, coverage for fees for 2nd medical opinion, and wellness services.

Drawbacks: The insurer recently closed shop on a few popular cancer plans owing to the high payouts (since they are one of the very few insurers that offer cancer coverage). This was unnecessary harassment for clients. The plan itself has a measly No-Claim Bonus that is capped at 50%, a cap (2% of the basic sum insured per hospitalisation) on its post-hospitalisation coverage, and multiple other disease-wise sub-limits.

How to Choose the Best Health Insurance Plans for Children in India?

When choosing the best health insurance plans for children, prioritise these -

1. A high No-Claim Bonus: It’s most likely that your child is healthy when you are purchasing the policy and won’t need to bank on it much. Subsequently, with a healthy lifestyle and physical exercises, he/she will continue to remain healthy.

The health insurance will continue to stay on as a faithful financial protection gear in dire events. And given the number of possible claim-free years, the chances are high that by the time he/she makes a claim, they will have an extremely high coverage at a nominal cost, provided you choose a plan that pays ample No-Claim Bonus (preferably without clawbacks).

2. A Wellness/Fitness program: Keeping your child healthy will become far more convenient if you have a wellness or fitness program imbibed in your health insurance plan for children. This will motivate them to stay physically and mentally well over consultations with nutritionists, discounts over premiums considering the monthly hours of workout/walking, etc.

3. A free annual health check-up: This will help you stay 1 step ahead in the diagnosis of any ailment acquired by your child or tracking the progress of a pre-existing condition. This will help you plan your finances accordingly.

4. OPD coverage (affordable premiums): A visit to the paediatrician is not exactly cheap and yet considering the low immunity among children such visits are a common occurrence. In this case, a solid OPD coverage wouldn’t hurt. However, make sure that when you choose a plan with OPD coverage, weigh out your losses regarding the spiked premium you will be paying, and the caps on total consultation charges (per year and visit).

5. Inflation shield: As your child grows older, medical inflation will lead to exponentially expensive healthcare services. With an inflation shield in place with your health insurance plan for children, he/she won’t have to worry about the sum insured falling short considering the spiked expenses.

Conclusion

A health insurance plan is a necessity for all, irrespective of their age. In the case of children, since we least expect it, we save for their higher educations and other life-stage events. But never a substantial amount for their medical requirements. A decent health insurance plan for children will help you get through the tough times without eating away at those savings that you have set aside for your child’s goals and dreams.